| Organization Name: | STRESS MANAGEMENT & MENTAL HEALTH CLINICS |
| NPI Number: | 1003928391 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CRAIG ALLAN MODELL (OWNER) |
| Mailing Address: | 10201 W Lincoln Ave # 308 West Allis |
| State: | WI US |
| Postal Code: | 532272136 |
| Phone Number: | 4143297000 |
| Fax Number: | 4143297010 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 02/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |